Preventing Injury
in Child Care
Settings
BCHealthPlanning
Preventing Injury
in Child Care
Settings
For more information, please contact the:
Ministry of Health Planning
Community Care Facilities Branch
Victoria BC V8W 3C8
This booklet can also be viewed on the internet, at:
www.healthplanning.gov.bc.ca/ccf
Canadian Cataloguing in Publication Data
Main entry under title:
Preventing Injury in Child Care Settings
Includes bibliographical references; p. 26
ISBN 0-7726-1995-6
1. Day care centers - British Columbia - Safety Measures. 2. Children’s
accidents - British Columbia - Prevention. 3. Safety education - British
Columbia.
I. British Columbia. Community Care Facilities Branch.
II. British Columbia. Office for Injury Prevention
III. Westcoast Child Care Resource Centre
HV675.72.P73 1993 363.1’07 C94-960009-1
Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
A. Injury Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Setting the Stage
Active and Positive Supervision
Safe Space Arrangement
Developmentally Appropriate Programming and Activities
Preventive Policies and Procedures
B. Child Proofing Indoor Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Furnishings
Windows
Phones
Plants
Hazardous Materials
Hallways and Stairways
Gates and Doors
Wiring, Electric Plugs & Appliances
Toys
Walkers
Kitchens
Sleeprooms
Bathrooms
Gyms or Gross Motor Areas
Family Day Care
Coping With Crisis
C. Childproofing Outdoor Settings . . . . . . . . . . . . . . . . . . . . . . .
Comings and Goings
Traffic Paths
Equipment
Resilient Surfaces
18
Plants
Pools and Ponds
Field Trips
Injury Prevention Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
References, Readings and Resources . . . . . . . . . . . . . . . . . . . . .
27
Introduction
Unintentional injuries are the single leading cause of death for
British Columbia children and youth aged 1-24. On average, a
British Columbia child or youth is hospitalized every 40 minutes
due to an unintentional injury. Each year more than 260 children are
killed and over 12,000 children are hospitalized as a result of
unintentional injuries.
We are concerned about the safety of our children. Whether the
setting is a family day care home, a preschool, a group day care,
other community settings, or parent’s home, the principles and
practices of injury Prevention serve as a foundation for ensuring
children’s safety.
The Government of British Columbia has placed increasing priority
on the prevention of injuries and illness. The Ministry of Health’s
PreventionCare initiative builds awareness of the extent to which
injury and illness are preventable and encourages British
Columbians to take action to protect themselves and their families.
This handbook provides an overview of the attitudes, knowledge
and skills required by caregivers in their day-to-day work with
children from birth through six years of age. It offers a practical
framework for understanding childhood injuries and concrete
suggestions for avoiding them!
Parents will also find the information useful in child-proofing their
own homes as well as checking the child care settings they have
chosen for their children.
For readers who wish to pursue Injury Prevention Issues in more
depth, a bibliography and resource list are included.
1
A. Injury Prevention
Setting the Stage
Did you know . . .
• the vast majority of injuries are predictable and preventable.
• most injuries to young children result from burns, poisoning and
choking or suffocation.
• most injuries to young children occur in the late afternoon or
early evening when they are tired.
• injuries in early childhood settings occur more frequently at
arrival and departure times than at other times of day.
• children are more likely to suffer injuries when they are
unfamiliar with a setting.
Learning, exploring and developing new skills always involve some
challenge and often, some risk! It is our responsibility to ensure the
safest environment possible.
Planning for children’s safety is the most effective tool for
preventing injuries.
A systematic approach to planning involves:
• Active and Positive Supervision
• Safe Space Arrangement
• Developmentally Appropriate Programming and Activities
• Preventive Policies and Procedures
3
Active and Positive Supervision
Adults who are involved, aware and appreciative of young children’s
behaviours are in the best position to safeguard their well-being.
Here are some things to consider:
Know each child’s abilities
Jennifer, a very active two year old, is fascinated with climbing but
has not yet mastered the skill of coming down the ladder. Carlos,
also age two, can manage this very well.
Establish clear and simple safety rules
"Inside we walk", "We climb up the ladder and come down the
slide" and "Our toys stay on the ground when we climb" are rules
that young children can understand.
Be aware of potential hazards
The log in the play yard is a source of much imaginative play.
However, after a heavy rain or cold spell, the log is slippery and
therefore "off limits" to the children.
Position yourself strategically
Standing nearby or being in the block play will encourage Sally to
remember the rule "Your building can be as tall as you are" and
discourage Michael from throwing blocks in frustration. Your
presence not only serves as a reminder but also enables you to
intervene quickly when needed.
Scan and circulate
Looking "up and out" and moving "with the action" are the best
ways to be aware of the group as a whole and to anticipate potential
trouble spots. Facing the open play space while sitting at the art
table enables you to move quickly to the climber when you see the
line-up growing.
Focus on the positive rather than the negative
Telling Dianne "Keep the water in the bucket" rather than "Don’t
splash the water" teaches her what is safe for herself, others and the
environment.
4
Redirect
Paul, a toddler, has a tendency to bite when frustrated. Knowing
this and positioning yourself close at hand will enable you to offer
him a hard, plastic biting toy when needed.
With Susy, a two year old who has a tendency to hit others when
angry, you might redirect her to the playdough table to "pinch and
punch" something that cannot be hurt.
Safe Space Arrangement
Careful planning for children’s play spaces can minimize the risk
of injury.
Here are some helpful suggestions:
Consider traffic flow
In arranging your learning centres, try to avoid long corridors or
large open spaces in the centre of the room. Both of these can lead
to overly excited play or running.
Define play spaces
Heavy plastic sheets under the water and sand tables will confine
the play, prevent slipping or falling and enable easy clean up.
Placing a border around the swings will ensure safety not only for
the "swingers" but for children involved in other activities.
Arrange the sleep area
Spacing sleep mats at least two feet apart will provide a path for
children to walk easily and safely. Providing night lights in a
darkened sleep room also will prevent tripping.
Plan for flexibility
When many children are excited about building a large block
structure, consider pushing back a shelf unit. This will create a safer
play space by avoiding congestion and decreasing frustration.
5
Developmentally Appropriate Programming
and Activities
Plan and offer activities which match the needs, skills and abilities
of the children in your care.
Here are some helpful strategies:
Provide appropriate activities
While toddlers enjoy placing precut vegetable pieces in a soup pot,
preschoolers can actually wash, peel and cut fruit for a salad.
While preschoolers welcome the challenge of hammering real nails
into a piece of wood, toddlers are safe and satisfied with using a
hammer and peg set.
For toddlers, walking along a strip of masking tape on the floor
provides a safer choice than balance beams which are more for
preschoolers.
Consider size and manageability
Children’s height, strength and physical abilities are key factors
when selecting tricycles, mounting hooks in cubbies or deciding to
purchase chairs with or without sides.
Similarly, the size and weight of equipment such as balls, boxes and
toys should ensure safe lifting, carrying or stacking.
When working with very young children, avoid small objects which
could be easily swallowed or put in their ears or nostrils.
Plan field trips with safety in mind
Ensure the equipment in your neighbourhood park is suitable for
the ages and developmental stages of your children.
Always try to select a route for your outing where crosswalks are
clearly marked and driveways are fewer.
Make sure there will be enough adult assistance to provide close
supervision.
Teach and review safety rules prior to your trip.
6
Preventive Policies and Procedures
Just as with all other areas of child care, policies for injury prevention
define what to do and procedures outline how best to do it! These
should be included in your Policies and Procedures Manual.
The following examples illustrate policies and procedures which
may be adopted for your setting.
Policy:
Field trips for our “over 3” group require one adult for
every three children.
Procedure: Prior to the field trip, a staff member will take
responsibility for enlisting help from parents
substitutes and/or volunteers.
Policy:
An injury prevention check will be completed every
six months.
Procedure: Using the injury prevention checklist form, the
condition of all indoor and outdoor equipment will be
recorded and reported to the Equipment Chairperson.
Any unsafe items will be removed or "off limits" until
repairs are made.
Policy:
A Reportable Incident form will be completed within
24 hours of the injury/incident.
Procedure: Staff present at the time of injury/incident will be
responsible for:
• notifying the parents/guardians
• completing and signing the form
• filing the original at the facility and submitting one
copy to the licensing officer
Policy:
All staff will have current First Aid certificates.
Procedure: When hiring staff, the Head Supervisor/Director will
record the expiry date of First Aid certificates for
future monitoring.
7
Policy:
All personal information required for handling children’s
emer gencies will be recorded and easily available at
all times.
Procedure: Completed and updated emergency information consent
cards will be kept in a file box beside the telephone.
Children’s cards will be taken on all field trips.
Policy:
Smoking when children are present is not permitted
for health and safety reasons.
Procedure: Adults who smoke must do so outside the home or
facility, in a designated area.
Adults who smoke are responsible for ensuring that
matches, lighters, cigarettes and ash trays are stored
securely out of children’s reach at all times.
Suggestion:
It is recommended that parents receive a copy of
your injury prevention policies when they receive
a copy of your discipline policies.
8
B. Childproofing
Indoor Settings
While the potential for injury is always around us,
these practical suggestions can help to childproof
the environment.
Furnishings
Young children love to hop and jump and therefore are vulnerable
to falls, bumps and bruises.
• Round the corners and edges of equipment such as cabinets,
shelves and tables to 1/2" ( 1.27 cm) radius.
• Keep furniture in good repair and free of sharp edges, splinters
and pinch or crush points.
• Use double sided tape so that area rugs lay flat and stay in place.
• Bolt cubbies and cabinets over 4' (1.22m) in height to the wall
using “L” shaped brackets.
• Store heavy objects on lower shelves.
Teach children to sit at tables when using small or pointed objects
such as pencils or scissors.
Windows
Windows in any child care setting can be a source of severe injury
to adventurous children.
• Ensure that low sliding windows open no more than 3 1/2" (9 cm).
• Be certain that windows which open out do not open into a
walkway or other path.
• Use tempered or laminated glass to avoid shards if broken.
• Keep drapery and blind cords out of children's reach.
• Use perspex or plexiglass to protect low windows where it is not
feasible to replace them with tempered or laminated glass.
• Protect glass in french doors with plexiglass or plywood or
replace the doors.
9
Phones
Phones are a necessary distraction from the care of children.
• Install phone connections in strategic locations.
• Tape long extension cords along walls or under furnishings to
prevent tripping.
• Consider using a cordless phone and taking the handset to areas
where supervision is required.
Plants
Some common household plants can be poisonous if young children
chew on or eat their leaves. Philodendron, for instance, is highly
toxic if swallowed and can also cause skin irritation. Dieffenbachia
or dumb cane and poinsettia can have similar effects. A leaf of either
plant can produce severe mouth pain and swelling of the tongue.
For a complete list of poisonous plants, contact your local Health
Unit or Department for a copy of the folder What About Plants?
or the Poison Control Centre at 682-5050 or 1-800-567-8911.
• Remove any hazardous or poisonous plants.
• Store plant bulbs and seeds out of children’s reach.
Hazardous Materials
A wide variety of materials can pose hazards to young children.
• All medications must be kept in a locked container.
• Check labels to avoid ingredients when purchasing art materials.
• Supervise children closely to ensure they don’t put paint,
brushes, crayons, pencils, pens or playdough in their mouths.
• Ensure that any toxic materials such as bleach or cleaning
products remain in their original labelled containers, well out of
children’s reach.
• Be sure that ceilings and walls have no cracked or broken
plaster and that there is no peeling or chipped paint.
• Repaint with non-lead paint those surfaces covered with
high-gloss enamel before 1970.
• Ensure careful supervision when children are using toys with
small parts or craft objects less than 1 1/2" (4 cm) in diameter
which could lodge in their throats, noses or ears.
10
• Provide safe storage for purses, tote or diaper bags which may
contain hazardous materials such as medications, skin preparations,
nail polish, cigarettes, matches, lighters, pencaps or jewellery.
Hallways and Stairs
There are some positive steps you can take to make hallways and
stairways safe.
• Ensure these areas are clear of toys, boxes, furniture or other
items that might limit safe access or pose a tripping hazard.
• Keep these passages well lit.
• Install handrails on both sides of stairways over 4' (1.22 m)
wide.
• Use solid plywood or vertical pickets placed closer than 4" (10
cm) apart to prevent children from falling through open spaces
between handrails and stairs.
Gates and Doors
When children are not permitted access to another floor or area of a
home or facility, these areas must be locked, blocked or gated.
• Secure doors with latches placed at adult height.
• Install safety gates at the top and bottom of all open stairways.
• Avoid safety gates with a “V” shape at the top so that children
do not get their necks caught and choke.
Wiring, Electric Plugs and Appliances
Prevention and planning related to anything electrical is critical!
• Make certain that children do not have access to pieces of metal
such as tweezers, hairpins or wire that they could push into
contacts of electric plug outlets.
• Check periodically that safety covers for electric plug outlets are
securely in place.
• Be very careful when electric plug outlets are located close to
grounding surfaces such as hot air or hot water registers. In these
situations, childproof electric plug outlets are recommended.
• Protect children from coming in contact with space heaters and
radiators hotter than 110oF (43oC).
11
• Place any space heaters at least 3' (90 cm) from curtains, paper
or furniture.
• Use ground fault interrupters when electric plug outlets are
located in a bathroom.
• Locate any small electric appliances such as hair dryers, radios,
kettles or toasters well away from sinks, tubs or water.
• Keep electric fans out of children's reach.
• Place or tape extension cords behind equipment or furniture to
prevent tripping. Alternately, loop the cord around the back leg
of a piece of furniture or cabinet. Never nail extension cords to
the wall!
• Test smoke detectors monthly and change batteries, if used,
twice yearly when you change your clocks.
Teach children safety rules regarding wiring, plugs
and appliances.
Toys
Toys bring delight, fun and learning to children, but they can also
be a source of injury.
• Check that toys are in good repair and free of sharp edges, pinch
points, splinters or broken parts.
• Repair or discard broken toys immediately so that scratches,
cuts and scrapes are avoided.
• Err on the side of caution when purchasing toys with small parts
for young children.
• Avoid the possibility of chocking by supervising very carefully
when children are using small objects such as crayons, marbles,
small bolts and beautiful junk!
• Ensure that young children do not have access to toys with
strings or cords longer than 6" (15 cm) to prevent strangulation.
• Think about using festive streamers rather than balloons which
can break and lodge in children's throats.
• Avoid toy boxes with lids as these can cause injury by falling
and pinching.
Teach children to replace toys in baskets, plastic tubs, cupboards
or shelves to eliminate tripping and falling over scattered items.
12
Walkers
While walkers can be fun for children, they present many hazards
by giving infants quick access to things such as:
• tables and table cloths
• stoves and hot ovens
• all electrical appliances
• electrical cords and plugs
• unprotected stairways
WARNING: Walkers are too hazardous to use in child care
settings as caregivers cannot provide the extra
attention required.
Kitchens
Toddlers love to pull out pots and pans from cupboards and
preschoolers love to participate in preparing foods! Still, some
precautions are in order.
• Store caustic detergents and all poisonous substances such as
bleach and cleaning solutions in cupboards with a lock or
childproof safety latches.
• Keep scissors, knives, needles and pins out of children's reach.
• Mop up any spills immediately to prevent slipping.
• Store plastic bags, which can be the cause of suffocation, well
away from children's reach.
• Take extra care if using styrofoam cups and plates or plastic
utensils as chewed or broken off pieces could lodge in the
child’s throat causing choking.
• Place pots and pans with their handles turned towards the back
of the stove to prevent spills causing burns.
• Be extremely careful while drinking or carrying hot items when
children are in the area.
• Ensure highchairs have a wide base to prevent tripping.
• Locate highchairs away from appliances, windows and sharp
corners of counters.
• Use safety straps while children are in highchairs or seated in
hook-on-table chairs.
13
WARNING: Avoid offering children under 4 years of age foods
that increase the risk of chocking, such as peanuts,
hard candy, popcorn, seeds or lumps of peanut
butter.
Be certain that hot dogs, raw fruits or vegetables
are cut in pieces too small to lodge in children's
throats.
Sleeprooms
Whether using a bedroom in a family home or a designated room in
a daycare centre, follow these safety tips.
• Purchase cribs manufactured after 1986 to ensure they meet
current Canadian regulations on crib safety. Cribs must now be
marked with the date they were manufactured.
• Be sure all crib parts are in good condition, with no loose or
missing slats.
• Locate cribs, beds and mats away from windows and blind cords.
• Ensure that there is no more than a 1" (12.5 cm) gap between
the mattress and the sides or ends of the crib.
• Check that the crib mattress support mechanism is secure.
• Use bumper pads which have no cuts or breaks.
• Prevent infants from falling out by discontinuing the use of bumper
pads and removing any large toys as soon as they can stand.
• Remove cords from pacifiers, if used, to prevent strangulation.
• Discontinue use of any mobiles, crib exercisers and other toys
strung over the crib when infants can sit up.
• Transfer children from cribs to beds or mats when they can
climb out of the crib.
• Consider using a nursery monitor in the infant sleep room when
you are involved elsewhere.
• Ensure that playpen walls are made of small mesh netting and
that the vinyl pad and rail covers have no breaks or cuts.
WARNING: Never offer propped bottles to infants. Never allow
children under 4 years of age to sleep on waterbeds
as these can cause suffocation.
14
Bathrooms
Childproofing the bathroom requires particular care and attention.
• Ensure that platforms or stools used by children to reach the
water taps are stable and will not slip.
• Store all toxic materials and cleaning products out of children's
reach in a high closet or cupboards with a lock or childproof latch.
• Never leave children unattended on the diaper change table or in
a bathtub.
• Make sure that containers of skin cream, lotion or powder are
well out of children's reach to prevent from inhaling or swallowing
these items.
• Prevent scalds and burns by installing control devises for all hot
temperatures water taps so that the water temperature does not
exceed 110oF (43oC).
• Test the temperature with your elbow before placing the child in
the tub or bath.
Teach children to turn on the cold water tap before turning on the
hot water tap.
Gyms or Gross Motor Areas
When children are involved in vigorous play, it is always a challenge
to prevent injuries from falls and collisions.
• Make sure that equipment is stable and has no sharp edges,
points, corners or splinters.
• Check climbers, slides, rocking boats and other equipment for
protruding nails or bolts and loose parts.
• Arrange equipment to prevent collisions and ensure a safe traffic
flow.
• Set up climbing equipment away from furniture, windows and
walls to prevent children from falling against them.
• Place resilient matting under and around structures that are
higher than 2" (60 cm) to protect children who may fall.
WARNING: Trampolines and rebounders are not recommended
for child care settings as they have caused many
head injuries.
15
Family Day Care
In a family setting, there are additional areas and items to consider
when planning for injury prevention.
Basements
• Take care that children do not have access to controls for the
furnace or hot water tank.
• Discard unused refrigerators.
• Keep paints, solvents, fertilizers, insecticides, laundry products
and any other toxic items in a high closet or cupboard with
childproof locks or latches
• Store flammable products far away from the furnace or hot
water tank.
• Ensure that washers or dryers are not used as climbing or
play spaces.
Workshops
• Ensure, wherever possible, that home workshops are not
accessible to children.
• Lock doors or cupboards where hazardous materials or tools are
kept if access to the outdoors is through the home workshop.
Fireplaces
• Screen fireplaces securely or equip them with protective guards.
• Clean chimneys at least once a year to prevent excessive
build-up of combustibles.
WARNING: Keep all alcoholic beverages out of children’s reach.
Ensure children do not have access to weapons,
ammunition and other potentially hazardous
objects.
Ensure compliance with federal laws regarding
storage of weapons and ammunition.
16
Coping with Crises
While up to 90% of injuries are predictable and preventable, it is
important to be prepared if emergencies do occur.
• Post next to the phone the number for:
~ 911 Emergency services
~ ambulance, fire and police where 911 is not in use.
~
Your facility's address and phone number
~
POISON CONTROL CENTRE
– Lower Mainland: 682-5050 or 682-2344
– Outside Lower Mainland: 1-800-567-8911
~ Local hospital
~ Ministry of Children and Family Development in the event
of suspected abuse
– Daytime: local office
– Evenings & Weekends:
– Lower Mainland 660-4827
– other B.C. Communities 1-800-663-9122
~ local Community Care Facilities Licensing Office
~ local Health Authority
~ alternate caregiver in case of emergency
• Keep in a small box by the phone up-to-date file cards which list:
~ work and home phone numbers of parents/guardians and
emergency contacts.
~ names, addresses and phone numbers of children's doctors
and dentists.
• Attach a list of contents to the inside cover or lid of all First Aid
Kits and check regularly!
• Keep four quarters in any portable First Aid Kits for emergency
phone calls to hospitals, parents, doctors or others; or have
ready access to a cellular phone.
Remember: You can dial 911 without using a coin! Make sure all
phone numbers and contacts are current!
17
C. Childproofing
Outdoor Settings
Some degree of risk is an important ingredient
of outdoor play. Our role is to minimize potential
injury by ensuring a safe environment and
supervising children carefully.
Comings and Goings
Here are some things to be aware of when children and their families
are coming to or leaving from your home or centre.
• Repair uneven joints in outside walkways to prevent tripping.
• Remove moss or algae from wooden walkways.
• Block any stairwells or sharp declines in the yard that have a
drop of 2' (60 cm) or more with 4' (1.22 m) fence.
• Install a handrail where stairs are more than 2' (60 cm) high.
• Close any open stairs by install risers at the back of each stair.
• Gate outside stairs from a deck at both the top and bottom.
• Check that fences and gates are stable and free of protruding
nails, nuts or bolts.
• Trim low branches from trees and shrubs to prevent eye damage
or scratches to the face.
• Sweep or clear walkways regularly.
Traffic Paths
When designing your playground, plan for clear circulation and
traffic paths for both people and wheel toys.
• Define carefully the space around and between swings and
slides to prevent collisions.
• Establish areas and rules for wheel toys - traffic signs, one-way
routes, parking areas, adequate turnarounds.
• Create a specific area for sand play.
18
Equipment
Careful selection, installation and ongoing maintenance are key to
playground safety!
• Consult your licensing officer for advice/guidelines when
planning or renovating your playground.
• Comply with manufacturer's instructions when installing equipment and ensure manufacturer's maintenance procedures are
followed so that warranties and guarantees are honoured.
• Check that climbing structures, footings, slides, rungs, steps,
ropes, cables and chains are secure, in good condition and free
of slivers or sharp edges.
• Ensure that swing hangers, chains and seats are in good repair
and “S” hooks are securely closed.
• Check that equipment parts are not broken, worn, cracked,
rusted, or missing and that nuts, bolts and screws are tight,
recessed and/or covered with plastic caps.
• Be sure that children are not wearing scarves, ties, clothes with
drawstrings or clothes that are too loose which may get caught
on equipment.
• Ensure that riding toys are well maintained and stable.
• Provide helmets for children riding tricycles or bicycles to
protect their heads and to encourage a lifelong habit.
Teach children how to use equipment safely.
Resilient Surfaces
More than 70% of all playground related injuries are from falls onto
hard surfaces. Various types of energy absorbing materials will
soften the impact of falls. These include loose materials like wood
chips, pea gravel and coarse washed sand or synthetic materials like
rubber and foam mats.
• Choose the resilient material which best suits your weather
conditions and the specific application.
• Avoid using pea gravel with infants and toddlers who are likely
to put these small bits into their ears, noses or mouths.
19
• Ensure that loose resilient surfaces are maintained between
6-12" (15-30 cm) in depth depending on equipment height.
• Rake sand or other loose resilient materials frequently to keep
them soft and to fill holes and bare spots.
Remember: Regularly check all traffic paths and surfaces
for litter, glass, sharp objects and animal droppings.
Plants
Many outdoor plants may cause stomach upsets, skin rashes,
internal organ damage and even death. In fact, almost half the calls
to the Poison Control Centre relate to plants!
Here are some examples of poisonous plants:
Trees
Shrubs
Vines
Horse Chestnut
Oak
Yew
Laburnum
Azalea
Climatis
Holly
Ivy
Hydrangea
Wisteria
Laurel
Rhododendron
Bulbs
Plants
Hyacinth
Daffodil
Crocus
Tulip
Anemone
Buttercup
Rhubarb leaves
Tomato leaf &
stem
From: “What About Plants” B.C. Poison Control Centre
• Remove, where possible, any hazardous outdoor plants.
• Trim any low branches from trees and bushes that cannot be
removed.
Teach children not to put leaves, stems, bark, seeds, berries, nuts
or wild mushrooms into their mouths.
20
Pools and Ponds
While pools and ponds are fun in hot weather, they present particular
hazards for young children.
• Supervise kiddy pools or plastic pools constantly while they are
in use.
• Store pools upside down when not in use.
• Protect children from drowning in ornamental ponds by draining
them, filling them in with sand or fencing them in.
Field Trips
Injuries are more likely to occur when there is a change in routine
or setting. Field trips have the potential for increasing children's
risk of injury.
• Check destinations and routes in advance, where feasible, to
identify opportunities and hazards.
• Recruit additional adults or volunteers to accompany the group
and provide extra supervision.
• Take along a portable first aid kit including coins for making
emergency phone calls.
• Carry with you emergency information/consent cards for
each child.
• Ensure that at least one staff member has a valid first aid certificate.
Vehicles
• Ensure that there are sufficient safety seats or seat belts for each
person and that these are correctly installed and used.
• Lock all vehicle doors when in motion.
• Keep emergency/consent cards for each child and a first aid kit
in each vehicle.
• Make a habit of carrying a blanket, water, some non-perishable
foods, a flashlight and winter emergency supplies.
• Find a safe place to pull over if a child or the group gets overly
excited.
• Use teachable moments to discuss traffic signs and road safety.
Remember: Never leave a child unattended in a vehicle!
21
D. Reviewing and
Reporting Incidents
When an injury occurs, much can be
learned about prevention from where,
when and how it occurred and how it was handled.
• Complete a Reportable Incident form and, when required,
submit one copy to your Licensing Officer.
• File all Incident Report forms in a central location, with a copy
in the child's file.
• Analyse completed reports periodically to determine any patterns
regarding time of day, equipment, location or supervision issues.
• Take corrective action, where appropriate, by adjusting your
schedule, removing or limiting the use of equipment, relocating
equipment or furnishings and/or increasing supervision.
22
Injury Prevention Checklist
Creating a safe environment is an ongoing process. This Injury
Prevention Checklist is a tool to assist you in this process.
Additional copies are available through your health unit/department.
While potential hazards may be identified by any number of people
- both children and adults - what matters most is that one individual
accepts responsibility for taking corrective action!
Indoor Settings
OK
✓
ACTION REQUIRED
PLEASE SPECIFY
ASSIGNED
TO
DATE
COMPLETED
Furnishings
• Furniture is in good repair & free of
sharp edges, splinters, pinch or
crunch points.
• Rugs are laying flat.
• Heavy objects are stored on lower
shelves.
Windows
• Drapery & blind cords are out of
children’s reach.
Plants
• Bulbs & seeds are stored out of
children’s reach.
• There are no hazardous or
poisonous plants.
Hazardous Materials
• Toxic materials & cleaning products
are in original containers & out of
children’s reach.
• Ceilings & walls are free of cracked or
broken plaster & peeling or chipped
paint.
Hallways & Stairways
• Clear of toys, boxes or other items
that may limit easy access or cause
tripping.
Gates & Doors
• Areas where children are not
permitted are protected by secured
doors or safety gates.
23
Indoor Settings
Wiring, Electric Plugs & Appliances
• Safety covers for electrical plug
outlets are in place.
• Space heaters are at least 3' (90cm)
away from flammable items.
• Small electrical appliances are well
away from sinks or tubs.
• Electrical fans are out of children’s
reach.
• Smoke detectors are tested every
month.
• Batteries in smoke detectors are
changed twice a year.
Toys
• Toys are in good repair & free of
sharp edges, pinch points, splinters
or broken parts.
Kitchens
• Poisonous materials are stored in
cupboards with locks or childproof
latches.
• Scissors, knives & other sharp items
are out of children’s reach.
• Plastic bags are not accessible to
children.
• Highchairs are located away from
appliances, windows and sharp
corners.
Sleeprooms
• Cribs are in good condition with no
loose or missing slats.
• Cribs, beds & mats are located away
from windows & blind cords.
• Cribs have less than 1" (2.5cm) gap
between matress and crib side or
edge.
• The crib mattress support
mechanism is secure.
• Bumper pads are free of cuts or breaks.
• Bumper pads & large toys have
been removed from cribs of infants
who can stand.
• Toys are not strung over cribs of
infants who can stand.
• Vinyl covered pads & rail covers for
playpens are free of cuts or breaks.
24
OK
✓
ACTION REQUIRED
PLEASE SPECIFY
ASSIGNED
TO
DATE
COMPLETED
Indoor Settings
OK
✓
ACTION REQUIRED
PLEASE SPECIFY
ASSIGNED
TO
DATE
COMPLETED
Gyms & Gross Motor Areas
• Equipment is free of loose parts or
bolts, protruding nails or splinters.
• Climbing equipment is located away
from windows, walls & other
furniture.
• Structures higher than 2' (60cm)
have resilient mats under & around
them.
Bathrooms
• Platforms or stools used at hand
basins are stable & slip proof.
• Toxic materials & cleaning products,
skin cream, lotions & powders are
not accessible to children.
Basements
• Paints, insecticides, laundry products
& other toxic items are not accessible
to children.
• Flammable products are stored
away from furnace or hot water
tank
Guns & Rifles
• Guns and rifles are unloaded &
locked away in an area not
accessible to children.
• Ammunition is stored separate from
the firearm & in a locked closet.
Alcohol
• Alcohol is out of children’s reach.
25
Outdoor Settings
Comings & Goings
• Fences & gates are stable and free
of protruding nails, nuts or bolts.
• Walkways are level.
• Low branches are trimmed from
tress and shrubs.
• Wooden walkways are free of moss
& algae and are non-slip.
• Walkways are swept regularly.
Equipment
• Climbing structures, slides & swings
are stable.
• Rungs, rails & steps are free of slivers
or sharp edges.
• Swing hangers, chairs & seats are in
good repair & “S” hooks are securely
closed.
• Equipment parts are not broken,
worn, cracked, rusted or missing.
• Nuts, bolts & screws are tight,
recessed and/or covered with plastic
caps.
• Ropes, chains & cables are in good
condition.
Resilient Surfaces
• Resilient material under & around
climbers & swings is between 6-12"
(15-30cm) deep, depending on
equipment height.
• Loose resilient materials are raked &
there are no holes or bare spots.
• Playground is free of litter, glass,
sharp objects & animal droppings.
Checklist completed by:
Date:
All follow up completed by:
Date:
26
OK
✓
ACTION REQUIRED
PLEASE SPECIFY
ASSIGNED
TO
DATE
COMPLETED
References, Reading and Resources
In both Canada and the United States, national pediatric and public health organizations
have recently published comprehensive references and guidelines for child care programs:
• Canadian Pediatric Society. Well Beings: A Guide to Promote the Physical Health,
Safety and Emotional Well-Being of Children in Child Care Centres and Family
Day Care Homes, Vol. 1 & 2. Ottawa Ont.: Canadian Pediatric Society, 1992.
(Available from Canadian Pediatric Society, 401 Smyth Road, Ottawa, ON, K1H 8L1).
• Caring For Our Children: National Health and Safety Performance Standards:
Guidelines for Out-of-Home Child Care Programs. Washington, DC: American
Public Health Assn./American Academy of Pediatrics, 1992.
Two other recent publications provide a wide ranging overview of health and safety
issues, including a focus on injury prevention, in child care programs.
• Shapiro, Kendrick A, Kaufman R. Messenger KP (eds). Healthy Young Children:
A Manual for Programs. Washington, DC: National Association for the Education of
Young Children, 1991 edition.
• Aronson, Susan S. Health and Safety in Child Care. New York, NY: Harper Collins,
1991.
For outdoor playground design and safety issues, two key publications, the first providing
a technical standard and the second an overview of safety and design principles are:
• A Guideline on Children’s Playspaces and Equipment. Toronto, Ont.: Canadian
Standards Association, CAN/CSA-A614-MM90, Rev. ed. 1991.
• Esbensen, Steen B. The Early Childhood Playground: An Outdoor Classroom.
Ypsilanti, MI: High Scope Press, 1987.
For both parents and caregiver there are a number of available books providing general
information on childproofing environments. These include:
• Vandervort, Don. Making Your Home Child-Safe. Menlo Park, CA: Sunset Books,
Lane Publishing, 1988.
• Stewart, Arlene. Childproofing Your Home. Addison Wesley, 1984.
• Miller, Jeanne. The Perfectly Safe Home. New York, NY: Simon & Shuster, 1991.
Videos also provide information about childproofing and injury prevention for both
adults and children. In child care settings these might be used with children and/or
parents as part of an injury prevention education program.
• KidsCare is a compilation of 2 videos, Home Safety With Radar for children and
An Instant In Time for parents. Distribution by the National Film Board of Canada
(contact 1-800-661-9867). The KidsCare initiative is a national awareness program on
child safety relating to consumer products and includes product safety information
materials suitable for display or distribution (contact Health Canada).
27
• Home Safe produced in conjunction with the Canadian Red Cross Society provides
information about first aid and injury prevention for parents and other caregivers.
• Good Beginnings: Family Day Care, the educational video series developed by the
Western Canada Family Day Care Association of BC, includes a video on Promoting
Health, Safety and Nutrition. (Available from WCFDCA or the Open Learning
Agency).
• Family Child Care Health and Safety Video and Checklist focuses on creating
safer home environments in family day care homes. (Available from Redleaf Press, St.
Paul, MN).
The Canadian Institute of Child Health (885 Meadowlands Drive East, Suite 512, Ottawa
ON., K2C 3N2) provides a range of safety and injury prevention related materials
including programs especially directed to parents and caregivers including:
• Safe Not Sorry and When Child’s Play is Adult Business booklets.
• Max the Safety Cat program which uses a handpuppet, Max, and accompanying
curriculum manual to deliver safety messages to young children.
Information and materials on traffic safety and seatbelt use for young children are
available through the Traffic Safety Programs Department of the Insurance Corporation
of BC. Information on bicycle safety and helmet use is available from Cycling BC.
Curriculum materials on both these areas is also available from the National Association
for the Education of Young Children in Washington, DC.
As part of the renewed focus on injury prevention education and action a number of new
initiatives are developing at the national and provincial level. These include:
• Safe Kids Canada will support public education, research and the development of
new prevention programs., Support will be provided to the development of local
injury prevention coalitions.
• Safe Start is a BC-wide injury prevention program coordinated by BC’s Children’s
Hospital. Safe Start will reach out to children most at risk by working within
communities to educate parents about potential hazards.
28
OIP 003
Rev. 2003/02/26